Ridhima Guniganti1, Enrico Giordan2,3, Ching-Jen Chen4, Isaac Josh Abecassis5, Michael R Levitt5,6, Andrew Durnford7, Jessica Smith8, Edgar A Samaniego9,10, Colin P Derdeyn9,10, Amanda Kwasnicki11, Ali Alaraj11, Adriaan R E Potgieser12, Samir Sur13, Stephanie H Chen13, Yoshiteru Tada14, Ethan Winkler15, Ryan R L Phelps15, Pui Man Rosalind Lai16, Rose Du16, Adib Abla15, Junichiro Satomi14, Robert M Starke13, J Marc C van Dijk12, Sepideh Amin-Hanjani11, Minako Hayakawa9,10, Bradley A Gross17, W Christopher Fox8, Diederik Bulters7, Louis J Kim5,6, Jason Sheehan4, Giuseppe Lanzino2,3, Jay F Piccirillo18, Akash P Kansagra1,19, Gregory J Zipfel1. 1. 1Department of Neurological Surgery. 2. Departments of4Neurological Surgery and. 3. 5Radiology, Mayo Clinic, Rochester, Minnesota. 4. 6Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia. 5. 7Department of Neurological Surgery and. 6. 8Stroke and Applied Neuroscience Center, University of Washington, Seattle, Washington. 7. 9Department of Neurosurgery, University of Southampton, University Hospital Southampton, United Kingdom. 8. 10Department of Neurological Surgery, University of Florida, Gainesville, Florida. 9. Departments of12Neurology and. 10. 13Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa. 11. 14Department of Neurological Surgery, University of Illinois at Chicago, Illinois. 12. 15Department of Neurological Surgery, University of Groningen, University Medical Center Groningen, The Netherlands. 13. 16Department of Neurological Surgery and Radiology, University of Miami, Florida. 14. 17Department of Neurosurgery, Institute of Biomedical Biosciences, Tokushima University Graduate School, Tokushima, Japan. 15. 18Weill Institute for Neurosciences, Department of Neurosurgery, University of California, San Francisco, California. 16. 19Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts. 17. 11Department of Neurological Surgery, University of Pittsburgh, Pennsylvania. 18. 3Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri. 19. 2Mallinckrodt Institute of Radiology, and.
Abstract
OBJECTIVE: Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. METHODS: Potential collaborators with established interest in the field were identified via systematic review of the literature. To ensure uniformity of data collection, a quality control process was instituted. Data were retrospectively obtained. RESULTS: CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. Many patients (85%, 911/1077) underwent treatment via endovascular embolization (55%, 587/1077), surgery (10%, 103/1077), radiosurgery (3%, 36/1077), or multimodal therapy (17%, 184/1077). The overall angiographic cure rate was 83% (758/911 treated), and treatment-related permanent neurological morbidity was 2% (27/1467 total procedures). The median time from diagnosis to follow-up was 380 days (IQR 120-1038.5 days). CONCLUSIONS: With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
OBJECTIVE: Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. METHODS: Potential collaborators with established interest in the field were identified via systematic review of the literature. To ensure uniformity of data collection, a quality control process was instituted. Data were retrospectively obtained. RESULTS: CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. Many patients (85%, 911/1077) underwent treatment via endovascular embolization (55%, 587/1077), surgery (10%, 103/1077), radiosurgery (3%, 36/1077), or multimodal therapy (17%, 184/1077). The overall angiographic cure rate was 83% (758/911 treated), and treatment-related permanent neurological morbidity was 2% (27/1467 total procedures). The median time from diagnosis to follow-up was 380 days (IQR 120-1038.5 days). CONCLUSIONS: With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
Authors: Matthew J Koch; Christopher J Stapleton; Ridhima Guniganti; Giuseppe Lanzino; Jason Sheehan; Ali Alaraj; Diederik Bulters; Louis Kim; W Christopher Fox; Bradley A Gross; Minako Hayakawa; J Marc C van DijK; Robert M Starke; Junichiro Satomi; Adam J Polifka; Gregory J Zipfel; Sepideh Amin-Hanjani Journal: Stroke Date: 2021-08-26 Impact factor: 10.170
Authors: Andrew J Durnford; Danyal Akarca; David Culliford; John Millar; Ridhima Guniganti; Enrico Giordan; Waleed Brinjikji; Ching-Jen Chen; Isaac Josh Abecassis; Michael Levitt; Adam J Polifka; Colin P Derdeyn; Edgar A Samaniego; Amanda Kwasnicki; Ali Alaraj; Adriaan R E Potgieser; Stephanie Chen; Yoshiteru Tada; Ryan Phelps; Adib Abla; Junichiro Satomi; Robert M Starke; J Marc C van Dijk; Sepideh Amin-Hanjani; Minako Hayakawa; Bradley Gross; W Christopher Fox; Louis Kim; Jason Sheehan; Giuseppe Lanzino; Akash P Kansagra; Rose Du; Rosalind Lai; Gregory J Zipfel; Diederik O Bulters Journal: Stroke Date: 2022-04-14 Impact factor: 10.170